Identifying the Pathway to Successful Patient Care: Practical Implementation of Incretin-Based Therapies in Type 2 Diabetes will present you with 3 interactive patient cases. You may choose to review each patient with type 2 diabetes in any order. Select a case from the left by clicking the 'Click To Enter Case' link. Once you enter the case and before answering questions, click on the patient’s tab to view his clinical presentation, medical history, and current medications.

After reviewing each diabetes case, you will be asked about changes you would recommend to improve the patient’s glycemic control; you will be given the opportunity to compare your decisions with those of other participants and with the recommendations of our expert faculty.

Each case will take approximately 30 minutes to complete.

Use your mouse to click on your selected answers in each case.

Upon completion of each case study, you will earn CME/CE credit and will be given the option to choose another case to earn more CEUs or exit the activity.

Table 2.5. Costs of Pharmacologic Agents Used for the Treatment of T2D[1-5]

Drug Class

Drug Cost
($ per month, rounded to nearest $1)

Sulfonylureas

Glipizidea

13

Glipizide, 24-h tabletsa

15

Glimepiridea

15

Glyburidea

19

Biguanides (Metformin)a

Metformina

32

Metformin, 24-h tabletsa

40

a-Glucosidase Inhibitors

Acarbosea

82

Miglitol

102

Human Insulinsd

Regular human insulind

67-73 (price dependent on brand)

NPH (isophane) insulind

67-73 (price dependent on brand)

Long-Acting Insulin Analogues

Insulin glargine

112

Insulin detemir

110

Rapid-Acting Insulin Analogues

Insulin aspartb

240

Insulin lisprob

226

Insulin glulisineb

201

Pre-Mixed Insulin Analogues

Aspart protamine/Aspart

226

Lispro protamine/lispro

220

Glinides

Nateglinidea

130-136 (price dependent on dose)

Repaglinide

210-420 (price dependent on dose)

DPP-4 Inhibitors

Sitagliptin

216

Saxagliptin

203

DPP-4 Inhibitor/Metformin

Sitagliptin/metformin

216

Saxagliptin/metformin

Pricing not available

Thiazolidinediones

Pioglitazone

257

Rosiglitazonee

143-266 (price dependent on dose)

Thiazolidinedione/Metformin

Pioglitazone/metformin

257

Rosiglitazone/metformine

162 – 281 (price dependent on dose)

GLP-1 Receptor Agonists

Exenatide

280

Liraglutide

280

Amylin Mimetics (Pramlintide)

280-350 (price dependent on dose)

aPrice based on generic version.bPrice based on least expensive option for 5 X 3 mL pens.cPrice based on 100 U/mL, 10 mL vial.dRegular and NPH (isophane) human insulin not recommended per AACE/ACE guidelines.[6]eRosiglitazone use has been restricted by the US FDA.[7]

Barzilai N, Mahoney E, Guo H, et al. Sitagliptin is well tolerated and leads to rapid improvement in blood glucose in the first days of monotherapy in patients aged 65 years and older with T2DM. ADA 69th Scientific Sessions; 587-P. Available at: http://professional.diabetes.org/Abstracts_Display.aspx?TYP=1&CID=73299.

Nathan D, Buse J, Davidson M, et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009;32:193-203.

National Center for Health Statistics. Health, United States, 2009: With Special Feature on Medical Technology. Table 24. Life expectancy at birth, at 65 years of age, and at 75 years of age, by race and sex: United States, selected years 1900-2006. Available at: http://www.cdc.gov/nchs/data/hus/hus09.pdf#listtables.

Skyler J, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Diabetes Care. 2009;32:187-192.